tumor management

  • 文章类型: Journal Article
    开发了用于光动力疗法(PDT)的天然和人工酶产氧系统,用于肿瘤治疗,然而,他们没有达到预期的疗效。此外,酶和光敏剂通常都需要载体来有效递送到肿瘤部位。这里,通过巧妙地将自级联增强的PDT与Zn2过载治疗相结合,开发了一种自级联增强的多模式肿瘤治疗。选择锰-卟啉(TCPP-Mn)作为光敏剂和过氧化氢酶(CAT)模拟物,其可以被包封在葡萄糖氧化酶(GOx)内。酸响应性沸石咪唑酯骨架8(ZIF-8)用作TCPP-Mn@GOx(T@G)的载体,达到TCPP-Mn@GOx@ZIF-8(T@G@Z)。T@G@Z表现出强大的抗肿瘤能力:在ZIF-8的结构降解后,GOx可以介导葡萄糖的氧化并生成过氧化氢(H2O2);TCPP-Mn可以催化H2O2转化为O2,进行自级联增强的PDT;同时,释放的Zn2+可以通过破坏线粒体膜电位来增强氧化应激并诱导线粒体功能障碍;免疫疗法可以激活抵抗原发肿瘤和肿瘤转移。自级联增强的T@G@Z显示了其在进一步肿瘤管理中的潜在应用。
    Natural and artificial enzyme oxygen-generating systems for photodynamic therapy (PDT) are developed for tumor treatment, yet they have fallen short of the desired efficacy. Moreover, both the enzymes and photosensitizers usually need carriers for efficient delivery to tumor sites. Here, a self-cascade-enhanced multimodal tumor therapy is developed by ingeniously integrating self-cascade-enhanced PDT with Zn2+-overloading therapy. Manganese-porphyrin (TCPP-Mn) is chosen both as the photosensitizer and catalase (CAT) mimic, which can be encapsulated within glucose oxidase (GOx). Acid-responsive zeolitic imidazolate framework-8 (ZIF-8) is applied as the carrier for TCPP-Mn@GOx (T@G), attaining TCPP-Mn@GOx@ZIF-8 (T@G@Z). T@G@Z demonstrates robust anti-tumor ability as follows: upon the structural degradation of ZIF-8, GOx can mediate the oxidation of glucose and generate hydrogen peroxide (H2O2); TCPP-Mn can catalyze H2O2 into O2 for self-cascade-enhanced PDT; meanwhile, the released Zn2+ can enhance oxidative stress and induce mitochondrial dysfunction by destroying mitochondrial membrane potential; furthermore, immunotherapy can be activated to resist primary tumor and tumor metastasis. The self-cascade-enhanced T@G@Z exhibited its potential application for further tumor management.
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  • 文章类型: Case Reports
    一种罕见的局部侵袭性血管肿瘤,青少年鼻咽血管纤维瘤(JNA)主要影响男性青少年。本文描述了一名14岁的男性患者,他表现为嗜睡和复发性鼻出血,这是JNA的症状。CT和MRI扫描证实血管肿块具有明显的局部侵袭,起源于蝶腭孔。CT血管造影后,这揭示了肿瘤的大量血液供应,并有助于有效切除,设计了一个有针对性的手术策略。组织病理学证实了肿瘤的良性性质,手术成功,患者顺利康复。这个案例增加了关于JNA的小文献。它强调了医疗保健专业人员在管理疾病时需要了解早期识别和仔细的术前准备的要求。
    A rare and locally aggressive vascular tumor, juvenile nasopharyngeal angiofibroma (JNA) mostly affects male teenagers. This paper describes a 14-year-old male patient who presented with lethargy and recurrent nasal bleeding, which are symptoms of JNA. CT and MRI scans confirmed a vascular mass with a significant local invasion originating from the sphenopalatine foramen. After a CT angiography, which revealed the tumor\'s large blood supply and helped with efficient excision, a focused surgical strategy was designed. Histopathology verified the benign nature of the tumor, and the operation was successful and the patient had a smooth recovery. This case adds to the little literature on JNA. It highlights the need for healthcare professionals to be aware of the requirement of early identification and careful presurgical preparation in managing the illness.
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  • 文章类型: Journal Article
    基于喹啉的成纤维细胞活化蛋白(FAP)抑制剂(FAPI)最近已成为全球核医学的焦点。强调了它们在癌症治疗和各种非肿瘤疾病的诊断中的有希望的应用。这篇综述对中国现有的FAPI示踪剂的发展和使用进行了深入的总结,追踪他们从临床前到临床研究的旅程。此外,这篇综述还评估了FAPIPET对中国最常见癌症的诊断准确性,分析了它对肿瘤管理范式的影响,并研究了FAP靶向放射性核素治疗在晚期或转移性癌症患者中的潜力。本文还总结了使用FAPIPET治疗中国非肿瘤疾病的研究。因此,这份定性概述提供了中国与FAPI示踪剂接触的快照,旨在指导未来的研究工作。
    Quinoline-based fibroblast activation protein (FAP) inhibitors (FAPIs) have recently emerged as a focal point in global nuclear medicine, underscored by their promising applications in cancer theranostics and the diagnosis of various nononcological conditions. This review offers an in-depth summary of the existing literature on the evolution and use of FAPI tracers in China, tracing their journey from preclinical to clinical research. Moreover, this review also assesses the diagnostic accuracy of FAPI PET for the most common cancers in China, analyzes its impact on oncologic management paradigms, and investigates the potential of FAP-targeted radionuclide therapy in patients with advanced or metastatic cancer. This review also summarizes studies using FAPI PET for nononcologic disorders in China. Thus, this qualitative overview presents a snapshot of China\'s engagement with FAPI tracers, aiming to guide future research endeavors.
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  • 文章类型: Journal Article
    基于揭示肿瘤细胞功能状态和分子表达的优势,正电子发射断层扫描(PET)成像已在许多类型的恶性疾病中进行诊断和监测。然而,图像质量不足,缺乏令人信服的评估工具以及人类工作中观察者和观察者之间的差异是众所周知的核医学成像的局限性,并限制了其临床应用。人工智能(AI)由于其强大的信息收集和解释能力,在医学成像领域引起了越来越多的兴趣。AI和PET成像的结合可能为管理患者的医生提供很大的帮助。Radiomics,人工智能在医学成像中的一个重要分支,可以提取图像的数百个抽象数学特征进行进一步分析。在这次审查中,概述了人工智能在PET成像中的应用,专注于图像增强,肿瘤检测,在几种类型的肿瘤中,响应和预后预测以及与病理或特定基因突变的相关性分析。我们的目的是描述基于AI的PET成像在恶性疾病中的最新临床应用,并着重于描述未来可能的发展。
    Based on the advantages of revealing the functional status and molecular expression of tumor cells, positron emission tomography (PET) imaging has been performed in numerous types of malignant diseases for diagnosis and monitoring. However, insufficient image quality, the lack of a convincing evaluation tool and intra- and interobserver variation in human work are well-known limitations of nuclear medicine imaging and restrict its clinical application. Artificial intelligence (AI) has gained increasing interest in the field of medical imaging due to its powerful information collection and interpretation ability. The combination of AI and PET imaging potentially provides great assistance to physicians managing patients. Radiomics, an important branch of AI applied in medical imaging, can extract hundreds of abstract mathematical features of images for further analysis. In this review, an overview of the applications of AI in PET imaging is provided, focusing on image enhancement, tumor detection, response and prognosis prediction and correlation analyses with pathology or specific gene mutations in several types of tumors. Our aim is to describe recent clinical applications of AI-based PET imaging in malignant diseases and to focus on the description of possible future developments.
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  • 文章类型: Journal Article
    The main challenges of cancer drugs are toxicity, effect on wound healing/patient outcome and in vivo instability. Polymeric scaffolds have been used separately for tissue regeneration in wound healing and as anticancer drug releasing devices. Bringing these two together in bifunctional scaffolds can provide a tool for postoperative local tumor management by promoting healthy tissue regrowth and to deliver anticancer drugs. Another addition to the versatility of polymeric scaffold is its recently discovered ability to act as 3D cell culture models for in vitro isolation and amplification of cancer cells for personalized drug screening and to recapitulate the tumor microenvironment. This review focuses on the repurposing of 3D polymeric scaffolds for local tumor-wound management and development of in vitro cell culture models.
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  • 文章类型: Journal Article
    近年来,怀孕期间妇科恶性肿瘤的发病率有所增加,主要是由于老年怀孕人数增加。妊娠期最常见的妇科恶性肿瘤是宫颈癌,占71.6%,其次是卵巢恶性肿瘤,占7.0%。子宫颈癌在妊娠期的发病率本身并不是很高,症状很容易与怀孕期间的其他疾病混淆。在怀孕期间,妇科检查是有限的,因此,误诊率较高。妊娠期宫颈癌的治疗与多种因素有关,如肿瘤大小,病理类型,妊娠期,淋巴结受累,和患者愿意维持妊娠。作为这些因素的原因,很难确定最佳治疗方法。本文就妊娠期宫颈癌诊治原则的研究进展作一综述,为了在有效治疗肿瘤和保护胎儿健康之间取得平衡,避免延误治疗和早产。
    In recent years, the incidence of gynecological malignant tumors during pregnancy has increased, mainly due to the increased number of old age pregnancy. The most common gynecological malignant tumors in pregnancy are cervical cancer, accounting for 71.6%, followed by ovarian malignant tumors, accounting for 7.0%. The incidence of cervical cancer in pregnancy is itself not very high, and the symptoms are easily confused with other diseases in pregnancy. During pregnancy, gynecological examination is limited, and therefore, the rate of misdiagnosis is higher. The treatment of cervical cancer during pregnancy is related to many factors, such as tumor size, pathological type, period of gestation, lymph node involvement, and patients\' willingness to maintain pregnancy. As a reason of these factors, it is difficult to determine the optimal treatment. This article reviews the research progress on the diagnosis and treatment principles of cervical cancer in pregnancy, in order to strike a balance between effective treatment of tumors and protection of fetal health, and avoid delays in treatment and preterm delivery.
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  • 文章类型: Journal Article
    OBJECTIVEThe aim of this study was to illustrate the demographic characteristics of meningioma patients and observe the effect of adjuvant radiation therapy on survival by using the Surveillance, Epidemiology, and End Results (SEER) database. More specifically, the authors aimed to answer the question of whether adjuvant radiotherapy following resection of atypical meningioma confers a cause-specific survival benefit. Additionally, they attempted to add to previous characterizations of the epidemiology of primary meningiomas and assess the effectiveness of the standard of care for benign and anaplastic meningiomas. They also sought to characterize the efficacy of various treatment options in atypical and anaplastic meningiomas separately since nearly all other analyses have grouped these two together despite varying treatment regimens for these behavior categories.METHODSSEER data from 1973 to 2015 were queried using appropriate ICD-O-3 codes for benign, atypical, and anaplastic meningiomas. Patient demographics, tumor characteristics, and treatment choices were analyzed. The effects of treatment were examined using a multivariate Cox proportional hazards model and Kaplan-Meier survival analysis.RESULTSA total of 57,998 patients were included in the analysis of demographic, meningioma, and treatment characteristics. Among this population, cases of unspecified WHO tumor grade were excluded in the multivariate analysis, leaving a total of 12,931 patients to examine outcomes among treatment paradigms. In benign meningiomas, gross-total resection (HR 0.289, p = 0.013) imparted a significant cause-specific survival benefit over no treatment. In anaplastic meningioma cases, adjuvant radiotherapy imparted a significant survival benefit following both subtotal (HR 0.089, p = 0.018) and gross-total (HR 0.162, p = 0.002) resection as compared to gross-total resection alone. In atypical tumors, gross-total resection plus radiotherapy did not significantly change the hazard risk (HR 1.353, p = 0.628) compared to gross-total resection alone. Similarly, it was found that adjuvant radiation did not significantly benefit survival after a subtotal resection (HR 1.440, p = 0.644).CONCLUSIONSThe results of this study demonstrate that the role of adjuvant radiotherapy, especially after the resection of atypical meningioma, remains somewhat unclear. Thus, given these results, prospective randomized clinical studies are warranted to provide clear information on the effects of adjuvant radiation in meningioma treatment.
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  • 文章类型: Journal Article
    OBJECTIVE: We sought to characterize patterns and treatment for intracranial meningiomas in the Surveillance, Epidemiology, and End Results set of cancer registries.
    METHODS: SEER data was queried from 2004-2012 for cases of intracranial meningioma using appropriate topography and histology codes.
    RESULTS: A total of 49,921 patients with intracranial meningioma were identified. The vast majority of cases were associated with a benign histology (n = 47,047, 94.2%). There were 21,145 patients (42.4%) who underwent surgical management, 2783 who received radiation alone (5.6%), and 25,993 who underwent surveillance only (52.1%). Surgical management decreased in frequency from 48.8% of all cases in 2004 to 38.3% of cases in 2012 (P < 0.001). Radiation alone remained stable over time with a range of 4.8%-6.3% of cases. Observation increased from 45.0% of cases in 2004 to 56.7% of cases in 2012 (P < 0.001). On unadjusted analysis, surgical management was associated with younger age and larger tumor size. The incidence of tumors <2 cm in size increased significantly over the study period from 29.7% in 2004 to 41.7% in 2012 (P < 0.001). After adjusting for tumor size, multivariable analysis demonstrated that the odds of observation as a primary management strategy were greater in 2012 relative to 2004 (odds ratio 1.33, 95% confidence interval 1.21-1.45).
    CONCLUSIONS: The incidence of intracranial meningiomas increased, while tumor size at the time of diagnosis decreased. Moreover, the number undergoing no treatment increased as a treatment strategy and was more likely employed for older patients, those of African-American race, and those with smaller tumors.
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